WO2013120213A1 - Support d'implant adaptatif - Google Patents

Support d'implant adaptatif Download PDF

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Publication number
WO2013120213A1
WO2013120213A1 PCT/CH2013/000026 CH2013000026W WO2013120213A1 WO 2013120213 A1 WO2013120213 A1 WO 2013120213A1 CH 2013000026 W CH2013000026 W CH 2013000026W WO 2013120213 A1 WO2013120213 A1 WO 2013120213A1
Authority
WO
WIPO (PCT)
Prior art keywords
bearing
joint body
impiantatlager
implant
layer
Prior art date
Application number
PCT/CH2013/000026
Other languages
German (de)
English (en)
Inventor
Hubert Pius NOETZLI
Christoph Martin Noetzli
Original Assignee
Noetzli Hubert Pius
Christoph Martin Noetzli
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Noetzli Hubert Pius, Christoph Martin Noetzli filed Critical Noetzli Hubert Pius
Publication of WO2013120213A1 publication Critical patent/WO2013120213A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/32—Joints for the hip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30621—Features concerning the anatomical functioning or articulation of the prosthetic joint
    • A61F2002/30639—Features concerning the anatomical functioning or articulation of the prosthetic joint having rolling elements between both articulating surfaces
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
    • A61F2002/30934—Special articulating surfaces

Definitions

  • the invention relates to an artificial implant bearing for artificial joint replacement, in particular in humans,
  • Kunsl joints have been successfully implanted in human medicine for a long time and are constantly being further developed.
  • hip joints e.g.
  • the inner joint body is usually formed from a ball placed on a shaft made of a hard material
  • the hard Gelenkkorperober Assembly here can be supported on a compact body that can transfer any forces well on the inner bearing on the shaft. There is little risk of breakage for this inner joint body, even if it consists of hard, less ductile ceramics, If the outer joint body made of the same hard material, it has good sliding properties, but also tends depending on the material thickness to high brittleness.
  • the inner surface of the outer joint body should be supported as an abutment against the inner joint body hard and stiff to have a low coefficient of friction and to produce little abrasion in the articular surface, the forces should be given out elastically and broadly supported. This can not be achieved by a rigid structure.
  • EP 0 444 382 A1 discloses a hip joint socket! Vleta ! known, which is to transfer the bearing forces of a hard inner shell via an elastic transmission element on a thin-walled outer shell and spread over a wide area on the underlying bone tissue.
  • This configuration has the significant disadvantage that the bearing forces are not directly, but only in predetermined
  • CONFIRMATION COPY Zones can be transferred from the hard inner shell into the outer shell and thereby the inner shell must be stiffened even stiffer than with a directly supported! fnnersschaie, which could transmit the force at least partially directly to the underlying material at the pressure point. So that the inner shell does not deform at the pressure point and thus massively increases the frictional forces, it must therefore be particularly stiff, which has the disadvantage that the outer shell can not be uniformly loaded but mainly at the edge where it attaches directly to the inner blades and only secondarily at the few points of contact with the transmission element. In the spaces between these points, the outer shell is loaded only indirectly and therefore can not exchange forces with the bone in these zones. So that the most natural possible stress of the bone can be maintained behind the outer shell, the outer shell should transmit as directly as possible the forces from the inner shell over its entire surface.
  • the described object can be achieved by a consistent separation of the functional properties in the structure of the joint body.
  • the inventive joint structure is characterized by an inherently compact and rigid inner joint body with hard Lagerfizze, by an intermediate layer of a base polymer with embedded bearing means of a hard, strigsarmen material and an outer joint body, which hugs by its modular structure under load on the bearing means and thus transfers the forces over a large area to the outer surface anchored in the bone.
  • inner joint body is based on the fact that this joint body is always inside the entire construct and has no direct contact with the bone.
  • the designation of external joint bodies is based on the fact that this joint body is located on the outside of the overall construct and is directly connected to the bone with its own bone interface.
  • outwardly arched bearing surfaces are also possible in the outer joint body, which should be limited to one side of the joint.
  • Rotary axis still mainly coincides with the main load direction of the bearing are the
  • Hip bearing according to US 5,989,294 and WO 2010/072606 AI is that the intermediate layer as Whole moved between the storage areas. This movement is controlled by the rolling movements of the ball and is always at most half as far as the actual gel movement, which results from the displacement of the two bearing surfaces relative to each other. However, in the case of gyroscopic movements, this relative displacement changes depending on the instantaneous axis of rotation, which can then lead to the movable intermediate layer having moved into a position which suddenly no longer permits a rolling movement in a new direction of rotation because the intermediate layer intermeshes with the Balls now already at the end stop of the bearing, although the movement in the new direction of rotation would still be possible. If, however, the bearing is still moved in this new direction of rotation, the balls are pushed over the bearing surfaces without being able to roll, which leads to great friction and additionally increased abrasion.
  • the problems described are solved in the inventive joint structure by the replacement of the balls / rolling elements by small plain bearings, which are installed in the intermediate layer.
  • the individual plain bearings can distribute the forces occurring over a larger contact surface and they can be arranged so that no or only partially resilient plain bearings are in those zones in which come mainly to lie in the physiological movement of the current axes of rotation. This can be prevented that individual of these plain bearings are exposed to high shear forces in particular, which could permanently damage these or the adjacent storage areas.
  • the inner Geienk entrepreneurial is to be designed in its shape so that it either transfers all forces occurring in the articular surface directly to an inner bearing with a fixed seat or is also embedded on the opposite side in an outer bearing.
  • pressure forces primarily arise under the force of influence in the interior of the joint body and the inner joint body has a very rigid and stable shape and thus forms the ideal basis for an adaptive counter bearing.
  • a base polymer forms the bearing structure for the bearing pins, which form the actual counter-bearings to the inner joint body.
  • the bearing means are preferably in the form of ⁇ -rings with a material cross-sectional diameter which corresponds approximately to the mean radius of the ring.
  • the individual bearing ring knows a height of about one
  • the bearing means consist of a hard, compact material and are only slightly elastic.
  • the warehouse center! lie on one side on the spherical bearing surface of the inner joint body and touch it on the contact surface. If the bearing means are designed as O-rings, the contact surface is ideally a contact circle.
  • the warehouse center! are slidable on the spherical bearing surface of the inner joint body, wherein its contact surface moves slidably on the spherical bearing surface.
  • the friction coefficient between the bearing means and the inner joint body can be kept low by an ideal material removal and also the
  • the two rubbing surfaces can be ideally controlled to a to guarantee a long service life.
  • the outer joint body is supported by the spherical Lagerfikiee on the bearing means, which in turn forms a contact surface.
  • the bearing means are configured as O-rings, the contact surface also forms on the outer Geienk emotions ideally a contact circle between the bearing rings and the bearing surface of the joint body.
  • the two contact circles are arranged on the bearing rings so that the force curve are passed directly through the center of the cross-sectional areas and the Haupi Krafti thus in turn are mainly exposed to compressive stresses.
  • the bearing rings can be made of a very hard and less elastic material without a high risk of breakage, as they are not subjected to bending or tensile stresses.
  • the bearing rings offer the advantage that they create many gaps between the contact lines on the sliding surface, which allow the storage of synovial fluid. This liquid serves as a lubricant between the Sleitober perennial and after a shortest movement a Gleitfäim between GSeitober perennial is formed.
  • This phenomenon can not be observed in the bearing rings as sliding partners on the spherical surface of the inner joint body.
  • the outer joint body is on the spherical bearing surface with a relatively thin shell as
  • Lined bearing layer on the one hand must be strong enough to absorb the bearing forces, but on the other hand should be sufficiently elastic to the forces introduced as many as possible
  • This storage layer can be divided into separate and distinct
  • This bearing layer, or these storage zones can additionally
  • Such positioning means which complicate a displacement of the bearing means relative to the outer joint body or even prevent.
  • Such positioning means if the bearing means are designed as O-rings, be configured in the bearing ring inside, for example, as a bearing pin and so keep the bearing rings at the intended location, but without introducing the bearing forces in the ring.
  • a net-like structure for example with a honeycomb pattern, can hold the bearing means in position on the outside.
  • the bearing means position can be secured by the embedding of the bearing means in the base polymer, wherein this structure can be held even at the outer edges by an edge on the outer boundary of the spherical bearing surface of the joint body, or at the edges of the storage zones.
  • the suspension structure consisting of the base polymer can be connected to the bearing means in such a way that it completely seals both the contact surfaces between the bearing means and the bearing surface and the bearing surface of the outer body itself against external influences.
  • This can be selected for the bearing layer of the outer joint body, a relatively elastic and resilient with high alternating loads material, which is also suitable to endure stress peaks without breakage risk.
  • the outer joint body consists of a further layer which has to take over the power transmission to the outer shell, but as ideally as possible distributes the resulting forces and thus decouples the burden of the bearing forces of the holder.
  • This layer can be made of any solid, uniform material or composite materials of any design, so that they can hold their elasticity over a long time and returns to the original form even with shock loads. The thickness and consistency of this layer depends on the one hand on the desired outer dimensions of the outer GeSenkMechs, but also on the overall stiffness / elasticity of the outer joint body to be achieved.
  • the outer shell of the outer joint body should be designed so that it can be anchored well in the bone and can be additionally secured with fixatives if necessary.
  • the outer surface is said to favor the bone arv / ingrowth, so that the outer joint body anchors well in the bone and is not loosened by the stress on the joint.
  • Fig. 1 is a schematic representation of an embodiment of the inventive implant storage.
  • Fig. 2 is a schematic representation of a section of the intermediate layer with the recessed bearing means, which are designed here as bearing rings.
  • Fig. 3 is a schematic representation of a section of the bearing layer of the outer joint body, which is divided in this embodiment in storage zones with their own intermediate layer containing symmetrically cut bearing rings.
  • the embodiment of the mantle bearing shown in Figure i shows an inventive hip joint assembly in the form of an artificial hip joint.
  • the inner joint body (1) is a ball of a teifen material with the hard, spherical bearing surface (10), by means of the inner bearing ⁇ 11 ⁇ can be placed on an implant ⁇ 12 ⁇ for fixation in the intramedullary canal of the femur ⁇ 15 ⁇ .
  • Such an implant (12) is usually referred to in technical language as a hip stem (12a).
  • the inner joint body (1) is firmly connected to the hip stem (12a) by a press fit in the inner bearing (11).
  • the outer joint body (2) consists in the illustrated embodiment of a thin bearing layer (21) with the bearing surface (20) of a tough material with high elasticity, a composite layer (22) made of a softer, highly elastic material for power transmission and load distribution of the Bearing layer ⁇ 21 ⁇ on the bone interface (23) of the outer joint body (2), which serves with its outer contact surface ⁇ 24 ⁇ for the transmission of bearing forces in the Acetabuium (25) of the pelvic bone.
  • the intermediate layer (3) consists of a bearing support structure ⁇ 31 ⁇ , in which individual bearing means (32) of a very hard and rigid material in the form of Lager ingen (32 a) are embedded, said Lagermsttei (32) in direct contact with both Bearing surface (10) of the inner joint body ⁇ 1 ⁇ and with the bearing surface (20 ⁇ of the outer joint body ⁇ 2 ⁇ transmit the forces from the inner GeSenkMech (1 ⁇ on the outer joint body (2).
  • the bearing support structure ⁇ 31) shows the interaction between the bearing support structure ⁇ 31) and the individual bearing rings (32a ⁇ .
  • the bearing rings ⁇ 32a ⁇ are bordered by the bearing support structure (31) and, depending on the diffusion density, also
  • the outer edge (210) of the bearing layer (21) of the outer joint body (2) is folded so that it forms a boundary for the bearing support structure (31), so that they can not move relative to the bearing layer ⁇ 21 ⁇ .
  • FIG. 3 shows a storage zone (21 a) completely and parts of adjacent
  • Bearing zones (21a) having the same structure In this embodiment, in a bearing zone (21a) 7
  • Inserted bearing rings (32 a) which are supported against each other on outer, inclined flats of regular length. This gives the storage zone (21a) a hexagonal shape and the inserted bearing rings (32a) can be brought closer together, which the entire
  • bearing rings (32a) are that the bearing rings (32a) mutually support each other on the flats so that, first, they form a bridge arch that prevents them from falling out when they come from the outside
  • the bearing rings (32a) Preventing the self-rotation of the bearing rings (32a) reduces the freedom of movement of the bearing rings (32a) relative to the bearing layer (21) of the bearing zone (21a) or the entire outer joint body (2) and thus the friction between the bearing rings (32a) and Lagerschscht (21)
  • the bearing zones (21a) can transmit the forces absorbed by them independently of each other into the rear layers of the joint body (2) and thus to an even better distribution Contribute forces on the rear layers of the joint body, which also improves the distribution of forces in the bone interface (23) of the outer joint body (2).
  • This embodiment of the storage layer (21) subdivided into storage zones (21a) completely redefines the force distribution scheme of the Gefenklager because the storage layer (21) can in itself deflect the force flow only over short distances and the majority of forces are transferred directly to the rear layers of the outer joint body (2) and its bone interface (23) initiated, which comes closest to the physiological joint structure.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un support d'implant destiné à une prothèse articulaire artificielle selon la revendication 1. Le support d'implant adaptatif selon l'invention est constitué d'un corps d'articulation intérieur comportant une surface de support sphérique, d'une couche intermédiaire réalisée en un polymère de base dans lequel sont incorporés des éléments de support réalisés en un matériau dur ayant une bonne résistance à l'usure, et d'un corps d'articulation extérieur présentant une structure modulaire lui permettant d'épouser lesdits éléments de support lorsqu'il subit une contrainte mécanique et de transmettre ainsi les forces à la surface extérieure ancrée dans l'os pour les y répartir en surface. La structure modulaire du corps d'articulation extérieur permet de définir séparément les propriétés des surfaces de support et la rigidité du corps, et d'effectuer une adaptation optimale à différentes sollicitations par des forces extérieures en transmettant celles-ci au corps d'articulation intérieur pour les y répartir en surface.
PCT/CH2013/000026 2012-02-13 2013-02-12 Support d'implant adaptatif WO2013120213A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CHPCT/CH2012/000041 2012-02-13
PCT/CH2012/000041 WO2013120210A1 (fr) 2012-02-13 2012-02-13 Support d'implant adaptatif

Publications (1)

Publication Number Publication Date
WO2013120213A1 true WO2013120213A1 (fr) 2013-08-22

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PCT/CH2012/000041 WO2013120210A1 (fr) 2012-02-13 2012-02-13 Support d'implant adaptatif
PCT/CH2013/000026 WO2013120213A1 (fr) 2012-02-13 2013-02-12 Support d'implant adaptatif

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Application Number Title Priority Date Filing Date
PCT/CH2012/000041 WO2013120210A1 (fr) 2012-02-13 2012-02-13 Support d'implant adaptatif

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Country Link
WO (2) WO2013120210A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180336A1 (fr) * 2018-03-22 2019-09-26 One Ortho Implant et instrument orthopediques a faibles coefficients de frottement
WO2020155376A1 (fr) * 2019-02-01 2020-08-06 北京爱康宜诚医疗器材有限公司 Prothèse de cavité glénoïde et prothèse articulaire la comprenant

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0444382A1 (fr) * 1990-03-01 1991-09-04 SULZER Medizinaltechnik AG Prothèse d'acétabule métallique utilisable sans ciment
FR2705883A1 (fr) * 1993-06-04 1994-12-09 Revest Michel Prothèse articulaire à roulement sphérique à billes.
WO1994029605A1 (fr) * 1993-06-04 1994-12-22 Michel Martial Revest Dispositif d'articulation a roulement spherique a billes
WO2010072606A1 (fr) * 2008-12-22 2010-07-01 Dot Gmbh Endoprothèse modulaire d'articulation de la hanche

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5989294A (en) * 1998-07-29 1999-11-23 Marlow; Aaron L. Ball-and-socket joint, particularly a prosthetic hip joint

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0444382A1 (fr) * 1990-03-01 1991-09-04 SULZER Medizinaltechnik AG Prothèse d'acétabule métallique utilisable sans ciment
FR2705883A1 (fr) * 1993-06-04 1994-12-09 Revest Michel Prothèse articulaire à roulement sphérique à billes.
WO1994029605A1 (fr) * 1993-06-04 1994-12-22 Michel Martial Revest Dispositif d'articulation a roulement spherique a billes
WO2010072606A1 (fr) * 2008-12-22 2010-07-01 Dot Gmbh Endoprothèse modulaire d'articulation de la hanche

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019180336A1 (fr) * 2018-03-22 2019-09-26 One Ortho Implant et instrument orthopediques a faibles coefficients de frottement
FR3079134A1 (fr) * 2018-03-22 2019-09-27 One Ortho Implant et instrument orthopediques a faibles coefficients de frottement
WO2020155376A1 (fr) * 2019-02-01 2020-08-06 北京爱康宜诚医疗器材有限公司 Prothèse de cavité glénoïde et prothèse articulaire la comprenant
US11291550B2 (en) 2019-02-01 2022-04-05 Beijing AK Medical Co., Ltd. Articular fossa prosthesis and articular prosthesis with articular fossa prosthesis

Also Published As

Publication number Publication date
WO2013120210A1 (fr) 2013-08-22

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